Provider Demographics
NPI:1013216290
Name:WALDEN, NANCY LOUISE (MED, LPC, RPT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LOUISE
Last Name:WALDEN
Suffix:
Gender:F
Credentials:MED, LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1872 HOFFMANN LN
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-4105
Mailing Address - Country:US
Mailing Address - Phone:830-534-2700
Mailing Address - Fax:830-626-1880
Practice Address - Street 1:19115 FM 2252
Practice Address - Street 2:STE. 12
Practice Address - City:GARDEN RIDGE
Practice Address - State:TX
Practice Address - Zip Code:78266-2577
Practice Address - Country:US
Practice Address - Phone:830-534-2700
Practice Address - Fax:830-626-1880
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-27
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62216101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional